gms | German Medical Science

Objective: Laminoplasty has been shown to be advantageous in adults. In pediatric patients however, there is limited experience with this method, especially concerning progressive kyphotic deformity or instability in adjacent segments. Here we investigate the safety of laminoplasty in pediatric neurosurgery focusing also on postoperative development.

Methods: Fifteen children underwent laminoplasty, mainly for removal of spinal tumors in our department over a period of 10 years.

Results: At the time of surgery, patients´ mean age was 9.2 years (range: 0-17 years). Laminoplasty was performed over 1-11 segments (mean: 4.3 segments). Laminoplasty was performed for tumors (n=11), decompression of arachnoidal cysts (n=2), a perineural cyst, and for correction of spinal cord deformity (n=1, each). There were no procedure-associated complications with the exception of dislocation of a screw in one patient. Epidural bleeding occurred postoperatively in one intramedullary subtotal tumor resection. Progressive kyphosis was noted only in one patient after laminoplasty from Th 3-11. There was no difference in outcome according to the method used for fixation of the laminae (sutures vs. platelets). Spinal instability was not observed in adjacent segments. Four children died during follow-up because of progressive tumor disease. Mean follow-up was 21 months.

Conclusion: We conclude that laminoplasty in children is safe and it might convey several advantages. Dorsal instrumentation was not necessary during follow-up in any instance.